Step-advanced rectangular flap: A novel technique for the reconstruction of soft-tissue defects overlying the Achilles tendon in children (an observational study).

Abstract:

:Soft-tissue defects overlying the Achilles tendon are common complications after bicycle or motorcycle spoke injuries in children and usually require surgical management by various flaps. There is no apparent consensus on the optimal choice of flaps for these injuries. We designed a novel step-advanced rectangular flap to reconstruct small to moderate soft-tissue defects around the Achilles tendon. This study was performed to review our experience and evaluate the clinical effectiveness of the step-advanced rectangular flap.From May, 2014 to September, 2016, 12 consecutive children with soft-tissue defects overlying the Achilles tendon caused by spoke injuries were treated with the step-advanced rectangular flap. The patients' general information, surgical details, and postoperative complications were recorded. The Mazur evaluation system was used to assess clinical outcomes.All patients were followed up for ≥12 months (range 12-38 months). All flaps survived completely. Superficial infection occurred in 2 patients and healed by second intention after dressing changes; the other patients' surgical wounds healed by primary intention. The scars around the flaps in 2 patients were remarkable, and all others showed good results in terms of flap color and texture. Ankle function was normal, and satisfactory results were obtained in all cases. According to the Mazur evaluation system, the results were excellent in 9 patients and good in 3, with an excellent and good rate of 100% at 12 months postoperatively.The rectangular advancement flap appears to be a simple and reliable method for small to moderate soft tissue defects overlying the Achilles tendon in children.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Zhang Y,Liu Y,Tian S,Song L,Peng A

doi

10.1097/MD.0000000000017268

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

e17268

issue

41

eissn

0025-7974

issn

1536-5964

pii

00005792-201910110-00006

journal_volume

98

pub_type

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